MEDICARE: TAMERA N ANDERSON LISW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	I.1801089	OH

General Provider Information

NPI Number	:	1750731089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMERA N ANDERSON LISW

Provider Business Mailing Address
First Line	:	10999 REED HARTMAN HWY STE 202
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45242-8301
Country	:	US
Telephone Number	:	513-802-9582
Fax Number	:	513-456-4219

Provider Business Practice Location Address
First Line	:	8857 CINCINNATI DAYTON RD STE 202
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-3192
Country	:	US
Telephone Number	:	513-802-9582
Fax Number	:	513-456-4219

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2016
Last Update Date	:	03/31/2024

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